title: Pre-treatment with a sinus node blockade, ivabradine, before coronary CT angiography: a retrospective audit.
abstract: OBJECTIVE
  To evaluate whether a simple pre-treatment regimen of sinus node inhibition by ivabradine taken at home for only 1 day resulted in a lower pre-scanning heart rate (HR) and reduced the need for intravenous beta-blockers (BB) prior to coronary computed tomography angiography (CTA).
  
  
  METHODS
  The pre-treatment regimen for coronary CTA changed from using no medication at home (group 1 patients) to the use of 5 mg ivabradine twice a day (group 2 patients), to using 7.5 mg ivabradine twice a day (group 3 patients). The target HR was the same for groups 1 and 2, but lower for group 3. HRs and the use of intravenous BB before coronary CTA was performed were compared between the study groups.
  
  
  RESULTS
  The mean HR immediately before the planned CTA procedure was significantly lower throughout groups 1-3 with values of 70 ± 12.9, 64.9 ± 9.8, and 63.2 ± 10.6 beats/min in groups 1, 2, and 3, respectively (p < 0.001). This resulted in a significantly diminished use of intravenous BB in group 2 (mean 5.1 ± 5.8 mg) compared to group 1 (mean 9 ± 7.6 mg; p = 0.002). The target HR of 65 beats/min was achieved in 37%, 47%, and 61% of groups 1, 2, and 3, respectively (p < 0.0001).
  
  
  CONCLUSIONS
  In conclusion, the administration of ivabradine tablets at home for only 1 day to patients scheduled for coronary CTA resulted in a significantly lower in-clinic HR and a significantly lower mean use of intravenous BB.
authors.affiliation: Department of cardiology, Odense University Hospital, Svendborg, Denmark. Jess.lambrechtsen@ouh.regionsyddanmark.dk
authors.forename: J
authors.initials: J
authors.lastname: Lambrechtsen
authors.forename: K
authors.initials: K
authors.lastname: Egstrup
mesh_terms: D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D000704:Analysis of Variance; D001552:Benzazepines / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D000077550:Ivabradine; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014283:Triiodobenzoic Acids
chemical_list: D000319:Adrenergic beta-Antagonists; D001552:Benzazepines; D003287:Contrast Media; D014283:Triiodobenzoic Acids; D000077550:Ivabradine; C044834:iodixanol